Senior Housing

Answer 1

form_title=Senior Housing form_header=11003 What is the current living arrangement for the care recipient?*= {Select One,Home (lives alone),Home (lives with spouse),Home (lives with partner),Home (with care services),Assisted Living,Residential Care Home,Lives with family,Hospital,Nursing Home,Retirement Community} How is the care recipient getting around?*= {Select One,Independent,Walker,Cane,Temporarily immobile due to injury,Wheelchair - can propel self,Wheelchair - needs help to propel,Bedridden - unable to bear weight} Would you like any personal care services along with regular care? (see below for specific personal services)*= () Not sure - prefer to see all options. () No - personal care services are not required. () Yes - care recipient needs the personal services selected below. () Bathing () Eating/feeding () Dressing/grooming () Toileting () Dispensing medication What is the length of time for housing or care needed?*= {Select One,Not sure - prefer to see all options.,Long-term care (10 weeks or more),Short-term care (Less than 10 weeks)} Who is it that you are needing care for?*= {Select One,Mother,Father,Spouse,Son,Daughter,Grandparent,Other Relative,Friend,Client,Myself}

Answer 2

form_title= Senior Housing form_header= Find the best senior housing for you or your loved ones. Do you require handicap accessibility?*= () Yes () No Do you have a service animal?*= () Yes () No What is your monthly budget?*= _ [50]

Answer 3

form_title­= Senior Housing form_header= Find senior housing for you or your loved ones. Are you looking for yourself or for a parent or other loved one?*= _ [50] Are you seeking independent housing or assisted living?*= _ [50] What is the time frame for moving?*= _ [50]

Answer 4

form_title­= Senior Housing form_header= Find senior housing for you or your loved ones. Where is the senior housing located?*= _ [50] How do you sign up for senior housing?*= () Yes () No How big is the senior housing?*= _ [50]